No soy? Starbucks steps up! Duncan Hines, too?

Glad I didn't give up on Starbucks.  There on my "home" Starbucks counter last week were some small nutrition bars with no soy on the label.  Lots of nuts, and tasted pretty good!

This is a big relief, since at times I'm hungry for lunch when I get there.

Then, an additional surprise at home!  Some Duncan Hines Simple Mornings muffin/quick-bread mix with no soy on the label! Not even in the "manufactured in a facility. . ." section.   I haven't written to them to check on whether there is soy in their flour.

Maybe things are looking up.  After all, a lot of people who never heard of Tamoxifen are unable to tolerate soy.

I wish you health.

Breast cancer, DCIS: Questions I wish I had asked

There are questions I only think about after I get home after a doctor's appointment, when the doctor has gone back to his Houston office or on a vacation.  I need a "question reminder note" pinned to my mitten like a little kid, or to my car sun visor.

And sometimes I don't realize what I should have asked until I fill out the patient feedback questionnaire.       The questions are sometimes general/all purpose but important.  Other times I don't have enough information from any research to know what I should ask:

Specific to breast cancer:  Looking back, the first day of the boost was worse than all the rest of my DCIS treatment by far.  How could have guessed what to ask,  what to expect.  I wish I had had a crystal ball.

 I would have asked the radiation oncologist (or my regular radiation therapist, who was better at talking to people:)

Exactly what happens that's different on the first day of the boost?  Please be specific.

What's the longest that first boost treatment can take?

My breasts are heavy and not firm:  will this complicate the first day?

If I had pressed for details, maybe I would have been prepared for an unfamiliar radiation therapist, rushing in and out, uncovering me endless times, changing my position, making adjustments. At the same time one of my regular therapists on my other side would be taking films to see if they were on target.  If I were a woman with five young kids, all this rushing around (combined with a really painful arm) might not have given me the shakes.

(Oh, and also: What medicine can I keep at home in case an itch develops without warning?)

And are any of my activities limited?

Good questions I did ask the surgeon about lumpectomy:

What will I be like after the procedure?

What will I be able to do?

Can I lift my little weights?

 Again, only with a crystal ball, would I have known before the lumpectomy to ask if I should buy a different bra or a bra to wear at night to keep my incision from any strain, since my breasts are not firm.)  Luckily, Divine intervention or research  prompted me to buy the little-unbra, almost like a regular little top.  And I did sleep in my soft regular bra for a few days.

Later, maybe next post, some General Questions to Ask Doctors.

Cut Cancer Worldwide? What about the US?

This week, medpage introduced me to the "25 by 25" goal - which aims to cut worldwide premature deaths from certain non-communicable diseases (NCDs) by 25% by the year 2025.  The article gives findings by researchers of Imperial College London, indicating if desired lower levels of six risk factors were met, we could at least get close to the 25% goal.  

Cancer, of course is one of the four targeted NCDs.  As far as I can tell, the 25% lower death goal figure is for all four NCDs together.  I need to check further, but my main concern is always cancer.

And the worldwide culprits that need reduction are " tobacco smoking, alcohol use, salt intake, obesity, blood pressure, and blood glucose and diabetes."  

My main question is:  will this plan work here in my country?  

I've read about pandemic tobacco smoking in at least one country that is a major factor in their cancer.  Cutting smoking there will help.  But smoking is lower here; cutting it further here may not make much difference in our premature cancer deaths. 

So my next question is:  will we really do anything about second and third-hand smoke here?  I am saddened and amazed by the  "nobody's gonna tell me what to do in our own car" crowd.  The babies in those cars go home to smoke saturated furniture, blankets and teddy bears. And I go forth into smoke-filled waiting rooms at doctors' offices Yes,I've ranted about third-hand smoke saturated clothes in waiting rooms. (Two weeks ago, two of us waited our turn in the hall because of smoke in the clothes and exhalations of one patient.)    Insert your own answer here. . . Will  your doctor ever say:  Do not smoke in the car!  You have a child!  Can your doctor and her patients afford to get HEPA filtered air in their waiting rooms?  

Then there is the matter of other pollutants.  Industrialized countries have their pollutants that we were genetically never intended to process.  In the EU, many such pollutants are forbidden in the food, the clothes, the air. So I say, are we going to do anything about pollutants here?   Would eliminating some of them automatically lower levels of the six culprit factors?

We should be able to get close to the targets levels.  In the medpage article  Rifat Atun, MBBS, MBA, of the Harvard School of Public Health points to:  "' . . .   highly cost-effective interventions available, which could be readily scaled up in all countries."   

I dare  say  the problem that's holding up reaching the target level of these Risk Factors is evident in our newspapers and online news every day.  As Atun adds: "'political apathy prevails.'"  

My political party has never asked me for money to cut pollution.  

Who you gonna call?  Anybody?

DRUG NEWS - Bypass Tamoxifen in our lifetime?

Mayo Clinic mentions low back pain as a possible side effect of Tamoxifen.  How is a woman with lumbar fusion supposed to know what is Tamoxifen and what isn't?  We can't just quit Tamoxifen for a month and see what happens.  I am almost fanatical about my posture this week.  And I still wonder if the spine is going bad next to the fusion.   Someone gave me a list of anxiety symptoms - back pain was the second one on the list.

While looking for more on this, I stumbled on a Mayo Clinic online magazine I didn't know existed. In a section called My Very Own Prescription, they report that a genetic difference in women affects how Tamoxifen can work.

Of course that reminded me of the Breast Cancer Hot Topics on medpage that I've mentioned here.

Mayo Clinic says researchers have been looking at women "who were unable to metabolize the drug to its most active form, endoxifen. Now these researchers are proposing to bypass the role for human metabolism by developing endoxifen as a drug."

NCI will work with Mayo Clinic on a trial that will be conducted there.

If you want to read that article, just Google Mayo Clinic Forefront and scroll down.

A far-off chance is better than none.

Breast Cancer: A new drug on its way for some?

A targeted therapy for HER2+/hormone receptor-negative (HR-) disease, with a new drug added, is now eligible for Stage III testing, according to medpage, April 11:  Novel Drug 'Graduates'. . . John W. Park, MD, of the University of California San Francisco, reported that a statistical model showed the regimen has a "'95% probability of superiority versus standard therapy and a 79% likelihood of success in Phase III.'"

This is wonderful, of course.

And yet I can't help wondering if women with other Breast cancers read the news with a sinking feeling that their ship has not come in.  Again.   

At least I hope these announcements of successful drug tests and planned drug tests remind all women that they are not forgotten.  That breast cancer is not forgotten.  But the progress is slow, and we are dwelling in dangerous times.  

Something strange just happened.  I went back to the Sunrise Rounds post I referred to yesterday, looking for a certain quote.  But it isn't there.  It's just a conclusion I drew from what Dr. Salwitz wrote:  Cancer rebuilds us.  And we wish there were some better way to get rebuilt.

So the tests go on, but. . .

The only thing that works for all breast cancers will be prevention.

I wish you health.

BREAST CANCER: What do we get for all this?

The last couple of days, I've been plagued with muscle hurts that may or may not be from Tamoxifen.  This morning, before I leave the house, I'm shamelessly grabbing another quote from Sunrise Rounds:

So, without being callous, I do not wish that cancer patients return to the person they were.  I hope that in trade for their struggle they gain new knowledge, grace, balance and perhaps peace.  Maybe they will come to understand a purity or beauty in a particular relationship, a fulfillment in their work, honesty in thought or simply the vital ability to just say, “No.”   James Salwitz, MD

(italics mine)

LUMBAR FUSION and feet and . . .

I had a backache yesterday, and maybe the day before.  And yesterday I also went to see a podiatrist for the second time in my life.  I was in the car far too long, partly because of parking problems, and there was a lot of bending in the podiatrist's office.  The back still aches.

The doctor told me more things than I could absorb at this busy and stressed time in my life.  One of them that I certainly will remember is his mention that the lower spine affects the nerves to our feet.  Why did I never think of that while preoccupied with how much the fusion surgery did or did not stop nerve pain in my legs.  

He said the lower spine could be related to feet hurting, burning, itching!  So maybe this new cream I use is not addressing that whole situation.   Maybe we should write ourselves a memo to ask doctors that all-important question:  What else could this be?

I was very resistant to the idea of custom orthotics because I don't ever find the the shoes I would need to put them in.  Also reluctant to get an x-ray after having what I feel is too many in TX, including the radiation for DCIS.

I'll take his suggestions for what to do first, like go and look at a certain shoe insert at the place where I got my ankle weights. Maybe buy the analgesic custom prescription.

And I'll redouble my efforts at better posture.  In desperation this morning, I used a flexible pack of baby wipes for a lumbar pad in my reading chair.  I'll also set the timer for a  half hour limit at the computer.

Mainly, I give him gold stars for patience, and for being a specialist who is aware of the rest of the body.  And I'll ask my primary doctor next week about exercises, maybe even Pilate's for spine health (without another X-ray, please?)  For now, I won't dwell on that tiny fear that the lower spine is in new trouble. It ain't over when the fusion's over.

I wish you health.